Session Information

Background/Purpose: Myeloid dendritic cells (mDCs) are potent T cell-activating antigen-presenting cells that have been implicated to play a crucial role in the regulation of tolerance and pro-inflammatory immune responses in many disease states, including rheumatoid arthritis (RA). Despite this, studies that have reported on the role of naturally occurring circulating mDCs in RA are scarce. Recently, CD1c mDCs from RA patients were suggested to migrate from the circulation to the joint where they exhibit a semi-mature phenotype. However, data on the capacity of these CD1c mDCs to regulate T cell activation in RA are lacking. The present study investigated the expression profiles of co-stimulatory molecules and pro-inflammatory mediators secreted by CD1c mDCs from synovial fluid (SF) versus peripheral blood (PB) of RA patients and studied their capacity to stimulate autologous CD4 T cell proliferation and cytokine production.

Methods: CD1c mDC numbers and their expression of surface molecules involved in T cell activation were assessed by FACS analysis in SF and PB from RA patients (n=9). Production of inflammatory mediators by CD1c mDCs from SF and PB of RA patients (n=6) was determined after 20h of culture by multiplex immunoassay (measuring 51 cytokines). The capacity of CD1c mDCs from SF (n=5) and PB (n=11) to activate autologous CD4 T cell proliferation in the absence of additional stimuli was measured after 6 days of culture by 3H-thymidine incorporation assay. Additionally, T-cell cytokine production was measured upon ionomycin/PMA restimulation.

Conclusion: The present study indicates that increased numbers of CD1c mDCs in SF play an essential role in the inflammation cascade by the secretion of specific T cell-attracting chemokines and the activation of self-reactive T cells to induce Th1, Th17, and Th2 activity. Targeting of CD1c mDCs or the specific triggers of these cells could represent a novel therapeutic approach to prevent immunopathology of RA.